Oocyte cryopreservation and reciprocal in vitro fertilization in a transgender man on long term testosterone gender-affirming hormone therapy: a case report

Objective

To report a successful case of oocyte cryopreservation and subsequent in vitro fertilization (IVF) in a transgender male receiving continued testosterone gender-affirming hormone therapy, followed by reciprocal embryo transfer (ET).

Design

A case report of a rare case of fertility preservation in a transgender man with concomitant use of testosterone therapy for 4 years before and during ovarian stimulation.

Setting

Private fertility clinic with university affiliation.

Patient(s)

A 26-year-old transgender man undergoing oocyte cryopreservation before gender-affirming surgery.

Intervention(s)

Fertility preservation using oocyte cryopreservation and IVF with reciprocal fresh ET into a cisfemale partner.

Main Outcome Measure(s)

Successful oocyte cryopreservation, oocyte thawing, and reciprocal IVF cycle.

Result(s)

Oocyte cryopreservation of 29 mature oocytes. Sixteen mature oocytes survived the thaw, and 12 were fertilized with intracytoplasmic sperm injection. A fresh ET of an advanced blastocyst resulted in a clinical pregnancy and live birth.

Conclusion(s)

Fertility preservation with oocyte cryopreservation or IVF with embryo cryopreservation is feasible for patients on continued long-term testosterone gender-affirming therapy. Future studies on egg quality and reproductive outcomes are required. Our case report demonstrates a promising outcome in this patient population.